Taking Care of Me

Taking Care of Me (TCOM) is a video-based intervention developed for persons with HIV. TCOM aims to increase clients’ early initiation of antiretroviral therapy (ART), ART adherence, and retention in HIV care.

About Taking Care of Me

Taking Care of Me (TCOM) is part of a set of widely disseminated video-based interventions, which includes VOICES/VOCES (V/V) and Safe in the City (SITC), that were tested in sexually transmitted disease (STD) clinics and found to be cost-beneficial and effective in reducing STD incidence. Based on the successful model developed for this previous set of videos, TCOM draws primarily from Social Cognitive Theory (SCT), the Information-Motivation-Behavioral Skills (IMB) model, and Social Action Theory (SAT). Together, these theories address the cognitive and behavioral factors that influence behaviors related to initiation of care, adherence, retention in care, and sexual risk reduction. SCT and SAT have also been used to guide other effective video-based educational interventions, including V/V and SITC.

The TCOM video contains open captions in English or subtitles in Spanish and is played on a continuous loop. It is comprised of three short dramatic vignettes that follow the stories of three persons with HIV:

  • Javier, a Latino gay man in his 20s;
  • Keisha, an African American heterosexual woman in her 30s; and
  • Michael, an African American gay man in his 30s.

TCOM intervention materials include waiting room posters that use images from the video designed to direct patients’ attention to the video and reinforce prevention messages.

Intervention Goals

  • Increase HIV treatment initiation
  • Improve viral suppression and achieve undetectable viral load
  • Increase retention in HIV care

Intervention Essential Elements

TCOM promotes:

  • Early initiation of ART among treatment-naïve clients;
  • Adherence to ART;
  • Retention in care among HIV-positive patients who are already on therapy;
  • Sexual risk reduction for HIV-positive minority persons; and
  • Communication between HIV-positive patients and their healthcare providers.

TCOM is:

  • Effective in increasing ART initiation and adherence;
  • Easy to use with no special training or space requirements;
  • Highly replicable and requires very little staff time, with no disruption to routine clinic flow;
  • Inexpensive;
  • Brief enough for patients to see most or all of it before they are called to their exam; and
  • Appealing to diverse audiences.

Intervention Audience

  • Patients attending HIV treatment clinics.

TCOM Training

There is no CDC-supported training currently available for TCOM. Technical assistance for the implementation of TCOM is available.

To request technical assistance:

  1. CDC’s directly funded health department and CBO partners may request technical assistance by submitting a request in the CBA Tracking System.
  2. Organizations not directly funded by CDC may contact their local health department for assistance in submitting a request.

If you have questions or need additional assistance, please contact HIVCBA@cdc.gov.

Implementation and Marketing Materials

The materials and resources listed below support the implementation and/or marketing of Taking Care of Me by health departments, community-based organizations, and health care or other organizations. The resources are evidence-based and designed for cost-effective, scalable implementation.

  • Warner L, Klausner JD, Rietmeijer CA, Malotte CK, O’Donnell L, Margolis AD, Greenwood GL, Richardson D, Vrungos S, O’Donnel CR, Borkowf CB, and the Safe in The City Study Group. Effect of a brief video intervention on Incident Infection among patients attending sexually transmitted disease clinics. PLoS Med 2008;5(6):e135.
  • Neumann MS, O’Donnell L, Doval AS, Schillinger J, Blank S, Ortiz-Rios E, Garcia T, O’Donnell CR. Effectiveness of the VOICES/VOCES sexually transmitted disease/human immunodeficiency virus prevention intervention when administered by health department staff: Does it work in the “real world”? Sex Transm Dis 2011;38(2):133-139.
  • Sweat M, O’Donnell C, O’Donnell L. Cost-effectiveness of a brief video-based HIV intervention for African American and Latino sexually transmitted disease clinic clients. AIDS 2001;15(6):781-787.
  • Gift TL, OʼDonnell LN, Rietmeijer Malotte KC, Klausner JD, Margolis AD, Borkowf CB, Kent CK, Warner L; Safe in the City Study Group. The program cost of a brief video intervention shown in sexually transmitted disease clinic waiting rooms. Sex Transm Dis 2016;43(1):61-64.
  • O’Donnell CR, O’Donnell L, San Doval A, Duran R, Labes K. Reductions in STD infections subsequent to an STD clinic visit. Using video-based patient education to supplement provider interactions. Sex Transm Dis 1998;25(3):161-168.
  • Besera GT, Cox S, Malotte CK, Rietmeijer CA, Klausner JD, O’Donnell L, Margolis AD, Warner L. Assessing patient exposure to a video-based intervention in STD clinic waiting rooms: Findings from the Safe in the City trial. Health Promot Pract 2016;17(5):731-738.
  • Harshbarger CL, O’Donnell LN, Warner L, Margolis AD, Richardson DB, Novey SR, Glover LC, Klausner JD, Malotte CK, Rietmeijer CA. Safe in the City: Effective prevention interventions for human immunodeficiency virus and sexually transmitted infections. Am J Prev Med 2012;42(5):468-472.
  • National Institutes of Health. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Published July 14, 2016. Available at: https://clinicalinfo.hiv.gov/en. Accessed April 16, 2017.
  • Zolopa A, Andersen J, Powderly W, Sanchez A, Sanne I, Suckow C, Hogg E, Komarow L. Early antiretroviral therapy reduces AIDS progression/death in individuals with acute opportunistic infections: A multicenter randomized strategy trial. PLoS One 2009;4(5):e5575.
  • Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, Hakim JG, Kumwenda J, Grinsztejn B, Pilotto JH, Godbole SV, Mehendale S, Chariyalertsak S, Santos BR, Mayer KH, Hoffman IF, Eshleman SH, Piwowar-Manning E, Wang L, Makhema J, Mills LA, de Bruyn G, Sanne I, Eron J, Gallant J, Havlir D, Swindells S, Ribaudo H, Elharrar V, Burns D, Taha TE, Nielsen-Saines K, Celentano D, Essex M, Fleming TR; HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365(6):493-505.
  • Neumann MS, Plant A, Margolis AD, Borkowf CB, Malotte CK, Rietmeijer CA, Flores SA, O’Donnell L, Robilotto S, Myint-U A, Montoya JA, Javanbakht M, Klausner JD. Effects of a brief video intervention on treatment initiation and adherence among patients attending human immunodeficiency virus treatment clinics. PLoS ONE 2018; 13(10): e0204599. https://doi.org/10.1371/journal.pone.0204599